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21 August 2012

Diseases of Civilization - Native Americans

In 1902, Aleš Hrdlička, physician-turned-anthropologist, in his Physiological and Medical Observations among the Indians of Southwestern United States and Northern Mexico, reported that:

"Malignant disease if they exist at all - that they do would be difficult to doubt - must be extremely rare." Hrdlička had not seen "unequivocal signs of malignant growth on an Indian bone."

"No cases of appendicitis, peritonitis, ulcer of the stomach, or of any grave disease of the liver was observed."

He also noted that Indians lived as long as or longer that the "whites", suggesting that the low incidence of chronic diseases among the natives cannot be explained by a low life expectancy.

Pima Indians:
In 1846, the Pima Indians (Arizona) were described by surgeon John Griffin "in fine health". They lived in abundance, they relied on food from the wild (meat, fish, vegetables, seasonal fruits) and their agriculture (corn, beans etc.). They kept storehouses of food (pumpkins, melons), yet obesity was unheard of.

Native Americans started to develop chronic diseases once they started to live on reservations (after 1846) and when their traditional diet was replaced by food of modern civilization: "sugar, coffee and canned goods". Food was provided by the the government to avoid starvation. This period is called by Pima Indians as "the years of famine".

When Hrdlička visited the Pima reservation in 1902 and 1905, he wrote: "[...] real obesity is found almost exclusively among the Indians on reservations."

Physicians at that time struggled with the dilemma of obesity among the poor, and health in abundant food supply. They tried to explain it with sedentary lifestyle. This theory did not confirm the sedentary behavior, yet good health of the Pueblo "who have been sedentary since ancient times."

Physicians also knew that the Pima's life was arduous (harvesting crops, wheat, carrying burdens), especially for women, who worked considerably harder than the men, yet the rate of obesity was higher among these women.

In the 1950s, Frank Hesse, physician at the Public Health Service Indian Hospital on the Gila Reservation noted that the Pima Indians diet consisted of "mainly beans, tortillas, chili peppers and coffee, while oatmeal and eggs are occasionally eaten for breakfast. Meat and vegetables are eaten only once or twice a week. [...] a large amount of soft drinks of all types are consumed between meals." One study described that "soda pop is consumed in immense amounts". (Hereandhere, more detail about their lifestyle and disease.)

The Sioux
Prior to their reservation life, the Sioux were mainly hunters, they were not used to consume fruits and vegetables.

When living on reservations, a study from the U.S. Department of Interior recorded that "An overwhelming majority of the Indians are poor". Their new diet consisted of beef, "grease bread, fried in fat and made from white flour, supplemented by oatmeal, potatoes, squash, canned tomatoes, coffee, canned milk and sugar. Butter, green vegetables and eggs were almost never eaten. Nearly two thirds of the families subsisted almost exclusively on bread and coffee.

This diet led to widespread obesity: 40% of the women, 25% of the men and 10% of the children were qualified as "distinctly fat", in the same time 20% of the women, 25% of the men, and a bit higher percentage of the children were "extremely thin". (I will write more about obesity and emaciation appearing usually in the same populations. Both are related to malnutrition, rather than to " too many or too little calories" consumed. Meanwhile, you can check out this post: Weight Loss.)